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Aim: Cannabis use is associated with greater likelihood of psychosis. The relationship between attitudes about cannabis and use has not been examined in youth at clinical high‐risk (CHR) for psychosis. Additionally, the shifting legal landscape can provide a valuable context for evaluating use and related attitudes. Methods: This study included 174 participants (44 CHR, 43 healthy control [HC] youth‐parent dyads). Youth completed measures of self‐reported cannabis use confirmed with a urinalysis, self‐perceived risk and perceived peer attitudes. Parents reported attitudes about youth use. Legalization occurred halfway during a 5‐year study in Colorado, providing an opportunity to cross‐sectionally examine its role in use and attitudes. Results: Frequency of youth reporting cannabis use was significantly higher in CHR (69%) than control group (30%). Use in CHR group was associated with higher perceived peer approval (r =.57), increased parental permissiveness (r =.28) and lower self‐perceived risk (r = −.26). Comparing samples participating pre and post‐legalization, use remained stable within each group. Group differences in parental permissiveness shifted; trend toward decrease in permissiveness in CHR group (η2partial =.07) and a significant increase in HCs (η2partial =.16) were observed. Post‐legalization, use in CHR group correlated with higher perceived peer approval (r =.64), lower self‐perceived risk (r = −.51) and higher parental permissiveness (r =.35, trend). Conclusions: Taken together, results indicate a relationship between self and peer/parental attitudes about cannabis and use in youth at CHR for psychosis. These factors are important to consider within the legalization context given the changes in parental attitudes and a stronger association between use and attitudes in this group post‐legalization. [ABSTRACT FROM AUTHOR]

Introduction: Contextual factors representing chronic stressors, such as neighborhood crime characteristics, have been repeatedly linked to compromised mental and physical health, and may contribute to the pathologizing of normative/non-clinical experiences. However, the impact of such structural factors has seldom been incorporated in Clinical High Risk (CHR) for psychosis research. Understanding how context can influence the presence or severity of symptoms such as suspiciousness/paranoia may have important relevance for promoting valid and reliable assessment, as well as for understanding ways in which environment may be related to illness development and expression.Methods: A total of 126 adolescents and young adults (nCHR = 63, ncontrol = 63) underwent clinical interviews for Clinical High-Risk syndromes. Neighborhood crime indices and socioeconomic status were calculated through geocoding and extracting of publicly available Census and Federal Bureau of Investigation (FBI) data. Analyses examined presence of associations between neighborhood crime indices, socioeconomic status, suspiciousness and total symptoms.Results: Greater neighborhood crime was related to increased suspiciousness in CHR individuals, even after controlling for neighborhood socioeconomic status, r = 0.27, p = .03. Neighborhood crime was not related to total symptoms, and neither was neighborhood socioeconomic status.Discussion: Results suggest neighborhood crime uniquely related to suspiciousness symptoms in CHR individuals, while this was not the case for healthy volunteers (HV). Future work will be critical for determining the extent to which assessors are pathologizing experiences that are normative for a particular context, or rather, if a stressful context is serving as a sufficient environmental stressor to unmask emerging psychosis. [ABSTRACT FROM AUTHOR]